Summer Camp Registration - BRCS
(All information you provide will be held in confidence.)

Please select all camps your child would like to attend.

*A separate form must be completed for each child.


Email address *
CAMPER INFORMATION
Last Name: *
Your answer
First Name: *
Your answer
Address: *
Your answer
City *
Your answer
State *
Your answer
Zip *
Your answer
Grade entering in the fall: *
PARENT INFORMATION
Parent/Legal Guardian: *
Your answer
Phone number *
Your answer
EMERGENCY CONTACT INFORMATION:
Emergency Contact: (if parent/guardian is unavailable) *
Your answer
Emergency Phone: *
Your answer
Emergency Phone 2:
Your answer
Other individuals allowed to pick up the student *
Your answer
HEALTH INFORMATION
Allergies or other concerns:
Your answer
List all medications, both prescribed and over the counter. (All medications will need to be turned in to the office. Please bring all medication in original containers.)
Your answer
CAMPER PHOTO RELEASE
I agree that photos of my child can be taken and used for camp social media purposes. *
Required
SUMMER CAMP REGISTRATION
My child would like to attend the selected camps: *
Required
Total payment is due prior to camp date. My total is: *
Your answer
Payment Method *
Required
EMAIL CONFIRMATION
Parent's Email: (camper confirmation will be sent by email) *
Your answer
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